rfp-490-27pdf--1-.pdf

State of New Hampshire

REQUEST FOR PROPOSAL

For

DENTAL BENEFITS ADMINISTRATION

RFP # 490-27

RESPONSE DUE BY:

May 27, 2026 at 2:00 PM Eastern Time (ET)

Department of Administrative Services Division of Risk and Benefits

Table of Contents

SECTION 1: INTRODUCTION

A. Background B. Objective

SECTION 2: BIDDING INSTRUCTIONS AND CONDITIONS

A. Proposal Conditions for The State of New Hampshire, Department of Administrative Services, Division of Risk and Benefits B. RFP Timetable C. Vendors wishing to attend the proposal closing may do so via Microsoft Teams at the following: 12 D. Accepting and Evaluating Proposals E. Evaluation Process F. Bidder Contacts

SECTION 3: REQUIRED PLAN DESIGNS & IMPLEMENTATION

Plan Design Plan Changes – Last Five Years Implementation Service Requirements

SECTION 4: NETWORK ACCESS & DISRUPTION

SECTION 5: PERFORMANCE GUARANTEES

SECTION 6: TECHNICAL QUESTIONNAIRE

Experience, Stability, & Contractual Administrative, Member, & Claims Paying Services Claims processing & appeals Cobra & self-pay administration Data Reporting & Network Provider Management

SECTION 7: FINANCIAL

A. Administrative Fees B. Network Discounts C. Claims Re-Pricing Analysis D. Allowances

SECTION 8: CLIENT REFERENCES

APPENDICES: GROUP INFORMATION

APPENDIX A: SONH 2026 DENTAL RFP DATA

APPENDIX B: REQUESTED PLAN DESIGNS FORM

APPENDIX C: STATE OF NH TRANSMITTAL LETTER

APPENDIX D: P-37 FORM CONTRACT

APPENDIX E: BUSINESS ASSOCIATE AGREEMENT

APPENDIX F: REQUIRED PROTECTION OF CONFIDENTIAL INFORMATION AND DATA SECURITY

APPENDIX G: PARTICIPATING BIDDER AGREEMENT

SECTION 1

SECTION 1: INTRODUCTION

This Request for Proposal (“RFP”) is issued by the Department of Administrative Services, acting through the Division of Risk and Benefits, for the procurement of dental benefits administration as described herein.

A. BACKGROUND

The State of New Hampshire (“State”) provides dental benefits to approximately 10,280 active employees (“Active Plan”) and COBRA participants located in New Hampshire and the surrounding New England states. Included in the Active Plan is a “Special Group” of approximately 560 subscribers and their dependents from other organizations that have legislatively been offered coverage under the State’s Health Benefit Plan.

Northeast Delta Dental has provided dental benefits to active employees since 1993. The active employee dental plan moved from a fully insured to a self-funded arrangement effective December 1, 2007 and currently utilizes the Delta Dental PPO and Delta Dental Premier National networks.

Active employee contributions are collectively bargained and the current per pay period (26 pay periods per year) contributions are $2 for employee only, $4 for employee plus one, and $6 per family for most unions and $4 regardless of tier for one union (New Hampshire Troopers Association). Part-time employees (working 30 to 37 hours per week) pay slightly higher contributions based on the number of hours worked.

Every two years, the State collectively bargains employee health benefits, including plan design, health promotion programs and employee-facing initiatives, with the State’s unions. There are seven unions represented including the State Employees’ Association of New Hampshire, SEIU 1984 (SEA), the New Hampshire Trooper’s Association (NHTA), Teamsters Local 633, New Hampshire Probation and Parole Officers Organization, New Hampshire State Law Enforcement and the New England Police Benevolent Association (NEPBA) with multiple Locals. At this time, all unions have agreed to the same Active Plan design.

B. OBJECTIVE

The State is seeking proposals to provide dental benefits administration while duplicating the State’s current benefit plans as closely as possible.

As mentioned above, all unions have independently agreed to the same Active Plan design. Due to the existence of collective bargaining agreements, the State requires vendors to duplicate the current Active Dental Plan’s designs outlined in Section 3. The State must be notified of any deviations. If no deviation in benefit design is identified within your response, the State will assume the dental plan can be duplicated exactly.

It is important to note that the State is currently participating in collective bargaining and negotiations with all of the unions. The dental administrator is expected to implement any changes resulting from these negotiations.

Further, the State’s contract for dental administration services requires the dental administrator to implement any changes in plan design to the Active Plan resulting from collective bargaining throughout the term of the contract. In addition, the dental administrator shall provide financial

SECTION 1

modeling as needed to assist the State with consideration of potential plan changes that arise during negotiations. It is possible for the State to be required to manage multiple plan designs to comply with each of the collectively bargained units. The State reserves the right within any contract awarded under this RFP to re-negotiate elements of the contract as required by collective bargaining agreements.

Contract Term, Implementation and Payment

The State seeks to contract with a qualified Vendor commencing upon approval from the Governor and Executive Council and ending on December 31, 2031, with the option to extend for up to two (2) additional years as mutually agreed and approved by the Governor and Executive Council. The administrative services outlined in this RFP shall commence on January 1, 2027. Implementation activities shall commence within seven (7) days of Governor and Executive Council (G&C) approval or September 1, 2026, whichever is later. Payments for contractual services shall commence January 1, 2027, and shall not be made during the implementation period.

SECTION 2

SECTION 2: BIDDING INSTRUCTIONS AND CONDITIONS

A. PROPOSAL CONDITIONS FOR THE STATE OF NEW HAMPSHIRE, DEPARTMENT OF

ADMINISTRATIVE SERVICES, DIVISION OF RISK AND BENEFITS

1. RFP SCOPE

The Department of Administrative Services, Division of Risk and Benefits, is soliciting proposals for Dental Benefits Administration Services as described in these procurement documents.

2. MANDATORY INSTRUCTIONS FOR BIDDERS

It is required that you complete all sections of the RFP and provide your proposal by the stated proposal submission deadline. Do not alter any parts of this RFP, to include the questions and the question numbering.

Failure to follow these instructions may be grounds for rejection of your RFP response.

3. REQUEST FOR PROPOSAL (RFP) POINT OF CONTACT AND INQUIRIES

1. Any inquiries or requests pertaining to this RFP, whether verbal or written, including questions related to the form contract P-37 and Business Associate Agreement, and other appendices must be submitted in writing to following contacts:

Ryan Fuller Christopher.R.Fuller@das.nh.gov

From release of this RFP until an award is made and announced regarding the selection of a bidder, all communication with personnel employed by or under contract with the State regarding this RFP is prohibited unless first approved by the point of contact above. State employees have been directed not to hold conferences and/or discussions concerning this RFP with any bidder during the selection process, unless otherwise authorized by the point of contact. Bidders may be disqualified for violating this restriction on communications.

a. All questions must be submitted in writing prior to the deadline for Bidder Inquiries and/or

Requests for Clarification (May 7, 2026 at 4:00 ET). The questions will be consolidated and/or paraphrased and responded to via a written addendum, or addenda that will be posted on the State's website on or before May 14, 2026. Note that this date is subject to change at the State's discretion.

b. In response to requested exceptions to the P-37, the State will review requested exceptions and accept, reject or note that it is open to discussion of the proposed exception with the selected Bidder at its sole discretion. Questions about or requested exceptions to the RFP, P-37, and/or any relevant attachments not raised during the inquiry period are waived. Oral statements, representations, clarifications, or modifications concerning the RFP shall not be binding upon the State.

c. The State may, at its discretion, amend this RFP on its own initiative or in response to issues raised by inquiries as it deems appropriate.

d. RFP inquiries must be submitted by an individual authorized to commit the organization to mailto:Christopher.R.Fuller@das.nh.gov provide the services necessary to meet the requirements of this RFP. The Bidder must include complete contact information including the Bidder's name, title, telephone number, and e-mail address.

4. ADDENDA

In the event it becomes necessary to add to or revise any part of this RFP prior to the scheduled proposal submittal deadline, the Division of Risk and Benefits shall post any Addenda on the State’s bidder website. In the event of an addendum/addenda to this RFP, the State, at its sole discretion, may extend the Proposal submission deadline, as it deems appropriate. Before your submission and periodically prior to the RFP closing, check the website for any addenda or other materials that may have been issued affecting the RFP. The web site address is https://das.nh.gov/purchasing/vendorresources.aspx.

5. BIDDER CERTIFICATIONS

All Bidders must be duly registered as a Bidder authorized to conduct business in the State of New Hampshire. Bidders shall comply with the certifications below at the time of submission and through the term of any contract which results from said proposal. Failure to comply shall be grounds for disqualification of proposal and/or the termination of any resultant contract.

• STATE OF NEW HAMPSHIRE VENDOR APPLICATION: Prior to bid award, Bidders must have a completed Bidder Application Package on file with the NH Bureau of Purchase and Property. See the following website for information on obtaining and filing the required forms (no fee): https://DAS.NH.Gov/Purchasing.

• NEW HAMPSHIRE SECRETARY OF STATE REGISTRATION: A bid award, in the form of a contract(s), will ONLY be awarded to a Vendor who is registered to do business AND in good standing with the State of New Hampshire. Please visit the following website to find out more about the requirements for registration with the NH Secretary of State:

https://www.sos.nh.gov/corporations-0.

6. PUBLIC DISCLOSURE

a. Disclosure of Information Submitted in Response to RFP Information submitted in response to this RFP (including all materials submitted in connection with it, such as attachments, exhibits, addenda, etc.), any resulting contract, and information provided during the contractual relationship may be subject to public disclosure under the State's Right-to-Know law, RSA 91-A.

Confidential, commercial or financial information may be exempt from public disclosure under RSA 91-A:5, IV. If a bidder believes any information submitted in response to this RFP should be kept confidential, the bidder must specifically identify that information where it appears in the submission in a manner that draws attention to the designation and must mark/stamp each page of the materials that the bidder claims must be exempt from disclosure as “CONFIDENTIAL.”

Bidders must also provide a letter to the person listed as the point of contact for this RFP, identifying the specific page number and section of the information you consider to be confidential, commercial, or financial and providing your rationale for each designation. Marking or designating an entire proposal, attachment or section as confidential shall neither be accepted https://das.nh.gov/purchasing/vendorresources.aspx https://das.nh.gov/Purchasing https://www.sos.nh.gov/corporations-0 nor honored by the State. Bidders must also provide a separate copy of the full and complete document, fully redacting those portions and shall note on the applicable page or pages that the redacted portion or portions are “confidential.” Marking or designating an entire proposal, attachment or section as confidential shall neither be accepted nor honored by the State.

Submissions which do not conform to these instructions by failing to include redactions and related reasons for redaction, or a letter indicating the proposal does not include any confidential information, or by including redactions which are contrary to these instructions or operative law may be rejected by the State as not conforming to the requirements of the proposal.

Pricing, which includes but is not limited to administrative fees and performance guarantees, in your proposal or any subsequently awarded contract shall be subject to public disclosure regardless of whether it is marked as confidential.

Notwithstanding a Bidder's designations, the State is obligated by the Right-to-Know law to conduct an independent analysis of the confidentiality of the information submitted in a proposal. If a request is made to the State by any person or entity to view or receive copies of any portion of your proposal, or if the State otherwise wishes to make your proposal public, the State shall first assess what information it is obligated to release. If you have not provided redactions in your proposal, the State will release the proposal in its entirety with only the redactions the State deems necessary (if any). If you have provided redactions in your proposal, the State will notify you that a request has been made or that the State wishes to make your proposal public. The State will indicate what, if any, information it has assessed is confidential and will not be released and specify the planned release date of the remaining portions of the proposal. To halt the release of information by the State, a Bidder must obtain and provide to the State, prior to the date specified in the notice, a court order valid and enforceable in the State of New Hampshire, at its sole expense, enjoining the release of the requested information.

By submitting a proposal, you acknowledge and agree that:

• The State may disclose any and all portions of the proposal or related materials which are not marked as confidential and/or which have not been specifically explained in the letter to the person identified as the point of contact for this RFP;

• The State is not obligated to comply with your designations regarding confidentiality and must conduct an independent analysis to assess the confidentiality of the information submitted in your proposal; and

• The State may, unless otherwise prohibited by court order, release the information on the date specified in the notice described above without any liability to you.

7. ELECTRONIC POSTING OF RESULTING CONTRACT

Pursuant to RSA 21-G:37, all responses to this RFP shall be considered confidential until the award of a contract. At the time of receipt of proposals, the State will post the number of responses received with no further information. No later than five (5) business days prior to submission of a contract to the Department of Administrative Services, the State will post the name and rank or score of each Bidder.

Pursuant to RSA 91-A and RSA 9-F:1, the Secretary of State will post to the public any document submitted to G&C for approval, including any resulting contract, on its website (https://sos.nh.gov/administration/miscellaneous/governor-executive-council/). By submitting a proposal, Bidder acknowledges and agrees that, in accordance with the above-mentioned statutes and policies, (and regardless of whether any specific request is made to https://sos.nh.gov/administration/miscellaneous/governor-executive-council/ view any document relating to this RFP), any contract resulting from this RFP that is submitted to G&C for approval will be made accessible to the public online.

8. TERMS OF SUBMISSION

The State assumes no responsibility for understandings or representations made by its officers or employees prior to and in the event of the execution of a contract, unless such understandings or representations are specifically incorporated into this RFP. Verbal discussions pertaining to modifications or clarifications of this RFP shall not be considered part of this RFP unless confirmed in writing. Any information provided by the Bidder verbally shall not be considered part of that Bidder's response. By submitting a proposal, a Bidder agrees that in no event shall the State be either responsible for or held liable for any costs incurred by a Bidder in the preparation of or in connection with the proposal, or for work performed prior to the effective date of a resulting contract. Proposals must be valid until the effective date of any resulting contract.

9. SUBMISSION FORMAT

Instructions, formats, and approaches for the development of RFP information contained within the RFP are designed to ensure that the submission of data essential to the understanding of the Vendor’s response is received in a consistent and comparable format.

Your RFP response must be clearly sectioned and tabbed as outlined within this RFP document.

(e.g. Section 2. Step 1, Step 2, etc.) There is no intent to limit the content of the responses in other than the Vendor’s favor, only to assist the evaluation committee in reviewing each response.

10. PROPOSAL SUBMISSION DEADLINE

All RFP submissions must be received at the Bureau of Purchase and Property electronically via email no later than 2:00 PM (ET) on May 27, 2026. Submissions received after the date and time specified will be marked as late and will not be considered.

Proposals shall remain valid from the proposal submission deadline for one hundred and eighty

(180) days, or until contract approval by Governor and Executive Council, whichever is later. A complete RFP submission will include responses to all sections of the RFP, including a complete response to the financial section. Incomplete submissions or submissions received after the date and time specified will be marked as late and will not be considered.

A Bidder's disclosure or distribution of proposals other than to the Department of Administrative Services, Bureau of Purchase and Property shall be grounds for disqualification. No more than one

(1) proposal per respondent shall be submitted.

11. RFP DELIVERY

Bidders shall submit their proposal via email to:

• NH.Purchasing@DAS.NH.Gov labeled with the following information:

State of New Hampshire RFP #490-27 Due Date: May 27, 2026 by 2:00 PM (ET)

Dental Benefits Administration mailto:NH.Purchasing@DAS.NH.Gov

Bidders are encouraged to confirm delivery of their submissions by calling (603) 271-2201 or by emailing NH.Purchasing@DAS.NH.Gov.

RFP responses must include:

i. One (1) complete electronic version of your RFP with responses to all questions in Sections

2 to 8, Appendices of this RFP, and any addenda and attachments. If you PDF your response, it must be a searchable document.

ii. One (1) redacted electronic copy of your entire RFP response, including a letter identifying confidential information as applicable.

iii. Appendix C, State of NH Transmittal Letter, signed by a person authorized to bind the company to all commitments made in the RFP response. Failure to submit the Transmittal Letter with your response will result in rejection of your response.

The State shall not be held liable for any costs incurred by the Bidder in preparing or submitting an RFP response.

12. ADDITIONAL INFORMATION

The State reserves the right to:

o Make a written request for additional information from a Bidder to assist in understanding or clarifying a proposal response.

o Waive minor or immaterial deviations from the RFP requirements, if determined to be in the best interest of the State.

o Omit any planned evaluation step if, in the State's view, the step is not needed.

o Reject any and all proposals, or any part thereof. Note that participating in this RFP process in no way obligates the State to pursue a contract with any of the Bidders participating in the RFP.

o Make independent investigation in evaluating a proposal.

o Consider available information regarding the Bidder, whether gained from the Bidder's proposal, question and answer conferences, references, or any other source during the evaluation process. This may include, but is not limited to, information from any other state or federal regulatory entity.

13. RESTRICTION OF CONTACT WITH STATE EMPLOYEES

From the release date of this RFP, all contact with the State regarding this RFP, except the point of contact specifically mentioned in Section 2.A.3 of this RFP, is prohibited. This prohibited contact includes personnel employed by or under contract with the State. Improper contact is grounds for rejection of your response.

14. CANCELLATION

Notwithstanding any other provision of this RFP, this RFP does not commit the State to award a contract. The State reserves the right, at its sole discretion, to reject any and all proposals, or any portions thereof; to cancel all or any part of this RFP at any time. Cancellation of this RFP, in whole or in part, shall not bar the State from issuing an RFP for the same services or from purchasing the same services through other means.

15. ETHICAL REQUIREMENTS

From the time this RFP is published until a contract is awarded, no Bidder shall offer or give, directly or indirectly, any gift, expense reimbursement, or honorarium, as defined by RSA 15-B, to any elected official, public official, public employee, constitutional official, or family member of any such official or employee who will or has selected, evaluated, or awarded an RFP, or similar submission. Any Bidder that violates RSA 21-G:38 shall be subject to prosecution for an offense under RSA 640:2. Any Bidder who has been convicted of an offense based on conduct in violation of this section, which has not been annulled, or who is subject to a pending criminal charge for such an offense, shall be disqualified from bidding on the RFP, or similar request for submission and every such Bidder shall be disqualified from bidding on any RFP or similar request for submission issued by any state agency.

16. SUBCONTRACTING

Contractor may perform certain services hereunder through one or more of its subsidiaries or affiliates. However, pursuant to Section 12 of the form contract P-37, subcontracting of services shall require prior approval by the State. If Bidder plans to utilize subcontractors for any portion of the Dental Benefits Administration Services identified in this RFP, please include the subcontractor information, an outline of the services or functions in which Bidder would plan to subcontract, the length of your relationship with the subcontractor, and a brief company profile.

A list of these subcontractors shall be attached to the contract with the selected Contractor and shall constitute prior approval by the State (of those subcontractors) consistent with Section 12 of the form contract P-37.

Contractor may, without prior written approval, contract with third-party vendors to provide information technology support services and other ancillary services, which are not Dental Benefits Administration Services hereunder, but rather are services that support Contractor's conduct of its business operations.

Contractor shall be accountable for the performance of all subsidiaries, affiliates, partner networks and subcontractors, and shall be responsible for all performance guarantee penalties that may result from underperformance of the subsidiary, affiliate and/or subcontractor.

17. REQUIRED CONTRACT TERMS AND CONDITIONS

The form contract P-37 (attached hereto as Appendix D) shall form the basis for any resulting contract. The successful Bidder and the State, following notification of award, shall promptly execute the P-37 contract, as amended by the parties to incorporate the service requirements of this RFP, price conditions established by the Bidder's offer, and any other reasonable administrative practices and services. In no event is a Bidder to submit its own standard contract terms and conditions as a replacement for one or all of the State's terms in response to this RFP.

The terms of this RFP and the selected Bidder's response will be used to form the terms of any resulting contract. References in the P-37 to Exhibits A, B, and C are references to the required structure of any resulting contract (Exhibit A - Special Provisions/Amendments to the P-37, Exhibit B - Scope of Services, and Exhibit C - Payment Terms) and are not references to sections of this

RFP.

The Business Associate Agreement (attached hereto as Appendix E), is required to comply with the Health Insurance Portability and Accountability Act, Public Law 104-191 and with the Standards for Privacy and Security of Individually Identifiable Health Information, 45 CFR Parts 160 and 164 and those parts of the HITECH Act applicable to business associates, shall be promptly executed by the successful Bidder and the State, following notification of contract award.

In addition to the Business Associate Agreement, the Bidder will be required to comply with the Required Protection of Confidential Information and Data Security (attached hereto as Appendix F).

State data will not be sold or aggregated for external reporting purposes without first consulting the State.

The State intends to incorporate this RFP and the selected Bidder's response into the resulting contract by reference. In the event there is a conflict between the resulting contract and the selected Bidder's response to the RFP, the term more favorable to the State shall control.

18. DEBARMENT

Bidders who are ineligible to bid on proposals issued by the Department of Administrative Services pursuant to the provisions of RSA 21-I:11-c shall not be considered eligible for an award under this RFP.

19. NON-COLLUSION

The Bidder's signature on a proposal submitted in response to this RFP guarantees that the prices, terms and conditions, and work quoted have been established without collusion with other vendors and without effort to preclude the State from obtaining the best possible competitive Proposal.

20. PROPERTY OF THE STATE

All material received in response to this RFP shall become the property of the State and will not be returned to the Bidder. Upon contract award, the State reserves the right to use any information presented in any proposal.

21. CHALLENGES TO IDENTIFICATION OF SELLECTED VENDOR

Within five (5) business days of the State's posting of the rank or score on its website, Bidders may, in accordance with RSA 21-G:37, request that the agency review its selection process. The request must be in writing and must specify all points on which the Bidder believes the agency erred in its process and shall contain such argument in support of its position as the Bidder seeks to present. In its request for review, a Bidder shall not submit, and the State will not accept nor consider, any substantive information that was not included in the original proposal. The State will respond to the request within five (5) business days of its receipt.

B. RFP TIMETABLE

The following table provides a Timetable for the RFP through contract finalization and approval. The State reserves the right to amend this Timetable at its sole discretion and at any time through a published Addendum.

Action Due Date (Eastern Time)

RFP Released April 30, 2026

Deadline for Vendor Inquiries and/or Requests for Clarification and Proposed Specification Changes

May 7, 2026, by 4:00 PM ET

Response to Vendor Inquiries and/or Requests for Clarification and Proposed Specification Changes

No later than May 14, 2026

Proposal Submission Deadline May 27, 2026, at 2:00 PM ET

Contract Implementation Period G&C Approval through December 31, 2026

Contract Effective Date January 1, 2027

C. VENDORS WISHING TO ATTEND THE PROPOSAL CLOSING MAY DO SO VIA MICROSOFT TEAMS

AT THE FOLLOWING:

Microsoft Teams meeting Join: https://teams.microsoft.com/meet/29933793831049?p=fjLEgs8GgRyIfiU7Rp Meeting ID: 299 337 938 310 49 Passcode: kc6452QH https://aka.ms/JoinTeamsMeeting?omkt=en-UShttps://teams.microsoft.com/l/meetup-join/19:meeting_M2NkZjNiMTItMjllOC00Njk2LTlhNjgtYjczMGE0NjlkY2Jl@thread.v2/0?con text={"Tid":"992deae9-1c4c-42c8-a310-5088af55ba74","Oid":"463a14e4-a708-45d4- 849b-9337540f32be"} Dial in by phone +1 603-931-4944,,184983608# United States, Concord Find a local number Phone conference ID: 184 983 608# Join on a video conferencing device Tenant key: nhgov@m.webex.com Video ID: 114 447 921 0

D. ACCEPTING AND EVALUATING PROPOSALS

The State reserves the right to:

a. Make independent investigations in evaluating Proposals;

b. Request additional information to clarify elements of a Proposal;

https://teams.microsoft.com/meet/29933793831049?p=fjLEgs8GgRyIfiU7Rp https://aka.ms/JoinTeamsMeeting?omkt=en-US https://teams.microsoft.com/l/meetup-join/19%3ameeting_M2NkZjNiMTItMjllOC00Njk2LTlhNjgtYjczMGE0NjlkY2Jl%40thread.v2/0?context=%7b%22Tid%22%3a%22992deae9-1c4c-42c8-a310-5088af55ba74%22%2c%22Oid%22%3a%22463a14e4-a708-45d4-849b-9337540f32be%22%7d https://teams.microsoft.com/l/meetup-join/19%3ameeting_M2NkZjNiMTItMjllOC00Njk2LTlhNjgtYjczMGE0NjlkY2Jl%40thread.v2/0?context=%7b%22Tid%22%3a%22992deae9-1c4c-42c8-a310-5088af55ba74%22%2c%22Oid%22%3a%22463a14e4-a708-45d4-849b-9337540f32be%22%7d https://teams.microsoft.com/l/meetup-join/19%3ameeting_M2NkZjNiMTItMjllOC00Njk2LTlhNjgtYjczMGE0NjlkY2Jl%40thread.v2/0?context=%7b%22Tid%22%3a%22992deae9-1c4c-42c8-a310-5088af55ba74%22%2c%22Oid%22%3a%22463a14e4-a708-45d4-849b-9337540f32be%22%7d https://teams.microsoft.com/l/meetup-join/19%3ameeting_M2NkZjNiMTItMjllOC00Njk2LTlhNjgtYjczMGE0NjlkY2Jl%40thread.v2/0?context=%7b%22Tid%22%3a%22992deae9-1c4c-42c8-a310-5088af55ba74%22%2c%22Oid%22%3a%22463a14e4-a708-45d4-849b-9337540f32be%22%7d tel:+16039314944,,184983608 https://dialin.teams.microsoft.com/f7a647af-ea74-46b0-81b7-19cbfe838a27?id=184983608 mailto:nhgov@m.webex.com

c. Waive minor or immaterial deviations from the RFP requirements, if determined to be in the best interest of the State;

d. Omit any planned evaluation step if, in the State’s view, the step is not needed;

e. At its sole discretion, reject any and all Proposals at any time; and

f. Open contract discussions with the second highest scoring Vendor and so on if the State is unable to reach an agreement on Contract terms with the higher scoring Vendor(s).

E. EVALUATION PROCESS

Segal Consulting has been retained by the State to assist in the evaluation of each Vendor’s responses for completeness and responsiveness to the RFP and to assist in the review of such responses. The State’s designated evaluation team will review and score Vendor responses and select the highest-ranking proposal. All proposals will be evaluated in accordance with the State procedures set forth in Steps 1 through 4 below.

Proposers are advised that this is not a low bid award and that the scoring of the financial section will be combined with the scoring of the non-financial section to determine the overall highest scoring Vendor.

STEP #1: MINIMUM QUALIFICATIONS

The State will conduct an initial screening to verify Vendor compliance with the minimum submission requirements set forth in the RFP. The State may waive or offer a limited opportunity to cure immaterial deviations from the RFP requirements if it is determined to be in the best interest of the State.

Each proposal shall be evaluated initially to determine compliance with the State of New Hampshire’s Minimum Qualifications. Any proposal that fails to meet one (1) or more of the following nine (9) qualifications shall be eliminated from further consideration for this contract. Any proposal that meets all of the minimum qualifications shall be further evaluated in accordance with the State’s selection criteria. Therefore, to receive further consideration, a proposal must check “YES” to each of the following questions and comply fully with the “Submission Requirement(s)” for each such qualification.

1. Is the Bidder able and willing to demonstrate its financial stability?

[ ] YES [ ] NO

Submission Requirements: a) Bidder’s most recent financial report; b) most recent independent auditor’s report; and c) SSAE 18, or equivalent external audit of Vendor’s operations. Attach to proposal.

2. Has the Bidder provided as part of its proposal the fee and rate information requested in the financial section?

[ ] YES [ ] NO

Submission Requirements: Full and complete responses to Section 7. Prepare all such responses on the financial worksheets included in this RFP. This section should be provided separate from the network access and disruption sections of the RFP. A separate electronic version must be provided containing this same information.

3. Has the Bidder provided as part of its proposal the network access and disruption information requested in this RFP?

[ ] YES [ ] NO

Submission Requirement(s): Full and complete responses to Section 4. Prepare all such responses on the network access and disruption worksheets included in this RFP. This section should be provided separately from the financial section of the RFP.

4. Has the Bidder responded to the performance guarantees set forth in the Performance

Guarantees Section 5 of the RFP and placed at least $100,000 at-risk annually?

Submission Requirement: Provide an annual at-risk amount of at least $100,000 and provide a complete response to the Performance Guarantees Section 5.

5. Has the Bidder provided as part of its proposal all information requested in this RFP including all information requested in the Technical Questionnaire Section 6?

[ ] YES [ ] NO

Submission Requirements: Full and complete responses to all of the information requests made in Section 6 of this RFP.

6. Does the Bidder have a dental network in the State of New Hampshire and the ability to administer the State’s dental benefit plan design as outlined in Section 3?

7. Has the Bidder provided as part of its proposal complete client reference information requested in the Client References Section 8?

[ ] YES [ ] NO

Submission Requirements: Full and complete responses to all of the information requested in Section 8.

8. Does the Bidder have experience working with a minimum of three (3) states, large municipalities, or other governmental entities?

[ ] YES [ ] NO

Submission Requirement(s): Demonstrate such experience by providing the total number of public entity clients with at least 5,000 subscribers.

9. Does the Bidder have experience servicing a client with at least 10,000 dental subscribers?

Submission Requirement(s): Demonstrate such experience by providing the total number of clients with at least 10,000 dental subscribers.

STEP #2: NON-FINANCIAL SCORING (50 TOTAL POINTS)

The Bidder’s response to information requested in Sections 4, 5, and 6 of the RFP will be evaluated based on the extent to which the Bidder documents conform with specifications, as well as the completeness, soundness, and creativity of the Bidder’s response, all as evaluated by the State.

The State will evaluate proposals based on technical criteria, including:

• Network Access Score – the extent to which the Bidder’s dental network provides adequate access for the State’s Active Dental Plan membership. (10 Points; Section 4)

• Disruption Score – the extent to which the State’s Active Dental Plan’s actual utilization was performed by providers in the Bidder’s dental network. (15 Points; Section 4)

• Performance Guarantees Score – the extent to which the Vendor demonstrates a willingness to agree to the requested performance guarantees and the proposed dollar amount at risk. (5 Points;

Section 5)

• Technical Questionnaire Score – the extent to which the Vendor demonstrates its o ability to provide the requested administrative, member, and claims paying services (15 points;

Section 6.B) o experience, stability, agreeable contractual terms and ability to provide data reporting and network provider management (5 points: Sections 6.A and 6.C).

STEP #3: FINANCIAL SCORING (50 TOTAL POINTS)

The financial proposals (Section 7) will be scored based on the total projected costs (TPC) (i.e., State paid claims, member paid, and administrative costs) as determined by the State for the five-year (5) period from January 1, 2027 to December 31, 2031. The lowest cost proposal will receive 100% of the 50 points allocated for the Financial Score. All other financial proposals will be scored on a sliding scale where the Bidder’s score will be reduced by 2 points for every percentage point it is higher than the lowest cost proposal. As the scale is sliding, scores will be adjusted for partial percentage differences.

The following exhibit illustrates how the financial score will be calculated from the 50 points available:

Formula

Example, where:

Lowest Bid TPC = $1,000 and Bidder TPC = $1,025

A Cost Difference = (Bidder’s TPC / Lowest Bid TPC) – 1 ($1,025 / $1,000) – 1 = 0.025

B Convert Decimal to Percent Value = A x 100 0.025 x 100 = 2.5

C 2 Point Reduction per Percentage Higher

= 2 x B 2 x 2.5 = 5.0

Bidder’s TPC Score = 50 - C 50 – 5.0 = 45.0

STEP #4: CONTRACT AWARD

As summarized in the chart below, each Bidder's technical score (as outlined above) will be combined with their financial score to determine the highest scoring bidder.

If the State decides to award a contract as a result of this RFP process, formal and final selection of the Bidder, is contingent upon the successful negotiation and the proper execution of all contract documents (acceptable to the State), approval of the Governor and Executive Council, and continued appropriation of funding for the contract. If the State is unable to reach agreement with the selected Bidder, the State may, at its sole discretion and at any time and without liability to the Bidder, immediately terminate such contract discussions with the Bidder and undertake discussion with the Bidder submitting the next highest ranked proposal, and so on. The State reserves the right to reject any or all proposals or any part thereof, cancel this RFP, or solicit new proposals under a new procurement process.

Criteria Points Section(s)

FINANCIAL 50 7

NETWORK ACCESS 10 4

DISRUPTION 15 4

PERFORMANCE GUARANTEES 5 5

TECHNICAL QUESTIONNAIRE 20

Administrative, Member & Claims Paying Services 15 6.B

Experience, Stability, Contractual, Data Reporting & Network Provider Management 5 6.A and 6.C

TOTAL POINTS 100

F. BIDDER CONTACTS

Designate the individual(s) with the following responsibilities:

The individual(s) representing your company during the RFP process:

Representative Name:______________________ Phone #:______________ Email: ___________________

The individual(s) responsible for day-to-day service (if different):

Representative Name:______________________ Phone #:______________ Email: ___________________

SECTION 3

SECTION 3: REQUIRED PLAN DESIGNS & IMPLEMENTATION

PLAN DESIGN

Due to the existence of collective bargaining agreements, the State requires Vendors to duplicate the active plan design.

Please review the attached Summaries of Benefits (indicated below) and complete the “Requested Plan Designs Form” located in Appendix B. If no deviations are provided on this form, it will be assumed that your organization can administer the current plan design exactly as written in the following attached Summary of Benefits.

Active Plan

• SONH-Delta-Dental-Benefit-Summary-2026.pdf

• SONH-Delta-Dental-Benefit-Booklet-2026.pdf

Passive Dental Network Plan – As illustrated in the plan design information provided, the State’s current dental plans are passive dental network plans, in which a member is subject to the same plan design regardless of whether dental care is performed by a network or non-network dentist.

Members receiving dental care at a network dentist are protected against balance billing. Members receiving dental care at a non-network dentist may be subject to balance billing and subject to a maximum allowable charge (or “reasonable & customary” fee schedule).

PLAN CHANGES – LAST FIVE YEARS

There have been no plan design changes in the last five years. The most recent change took place in 2016 when the calendar year member maximum increased from $1,500 to $2,000 for non-orthodontic services.

IMPLEMENTATION

Implementation activities shall commence within seven days of Governor and Executive Council (G&C) approval, or September 1, 2026, whichever is later.

The Bidder shall provide a preliminary implementation plan and timeline in its proposal and identify its implementation team members, as well as the State resources required for the implementation. No later than one week after Governor & Executive Council approval, the Bidder shall submit a detailed implementation plan and timeline to meet the State’s needs and subject to the State’s approval that will include but not be limited to the following:

• Key implementation team member(s), including their contact information

• Development of eligibility and enrollment interface between Vendor and State system, including all special campaigns per the collective bargaining agreements

• Import and testing of existing enrollment data from State

• Successful test of claims adjudication

• Successful transfer of data from the State’s current dental administrator, including but not limited to:

o Claims history, including orthodontics lifetime maximum data o Calendar year deductible payments in the event of an off-plan anniversary administrator change (this is not anticipated)

• Development of process for ongoing data transfer between the State’s claims data management system (when determined and in place) and the Vendor

• Establish process for data and reporting access for the State

• Development of a Comprehensive Communication plan with defined targeted audiences to include but not be limited to DAS, employees, state agencies, providers and other plan participants

• Support of the State’s November 2026 Open Enrollment for the 2027 Plan Year

• Include examples of proposed employee communications newsletters, posters, etc.

• Delivery of dental benefit program information and ID cards to plan participants prior to

January 1, 2027

• Access to Member Services on or no later than the 1st business day after January 1, 2027

• Access to and training on the Vendor’s online client and member portals as directed by the

State

• Any other item that is determined to be necessary for successful implementation.

The implementation project plan shall be updated thereafter as the State and Vendor mutually agree. Implementation activities shall be conducted in close collaboration and with the approval of the DAS.

Confirm you agree to the following:

1. Confirm that there will be no additional fees charged for any start-up costs including, but not limited to, the above services required in the implementation timeline. If there are any additional fees, they must be included in the Financial Section of this RFP.

2. Confirm that participant ID cards, enrollment materials, and benefit booklets/summary plan descriptions will be produced and distributed by January 1, 2027, as part of your implementation at no additional cost to the State.

3. Confirm that you will have final benefit booklets/summaries available to the State by November 1st each year for the purposes of open enrollment, or by a date mutually agreed upon.

4. Confirm you will promptly transfer enrollment cards, claim information, and other administrative records to the State or any carrier/TPA that would replace you in the event of termination of this contract at no charge.

SERVICE REQUIREMENTS

The requirements set forth below shall be minimum service requirements to be provided by the successful Vendor:

1. The State requires Vendor to provide dedicated staff in the following specialties:

a. Implementation Manager

b. Account Executive

c. Customer Service Manager

2. The State requires the assignment of a dedicated Account Executive that shall be accountable to the State for proactive management of all aspects of the Vendor’s performance to the State and its members. The Account Executive shall remain constant, within the Vendor’s control, for at least the first 18 months of the contact period. The Vendor shall not change assignment of the Account Executive without written notice provided to the State with a minimum of fourteen (14) days prior to such change. The State reserves the right to request assignment of a new Account Executive and the Vendor shall make such change within 30 days of receipt of written notice from the State.

3. The Vendor shall provide designated customer service representatives who are knowledgeable of the State’s plan via a toll-free phone number to be answered by a live person in the United States from, at a minimum, 8AM to 4:45PM ET Monday to Friday.

4. The State prefers claims invoices to be sent on a bi-weekly (every two weeks) basis for the prior two weeks of claims. Alternatively, the State would also accept claim invoices on a semi-monthly (twice a month) basis. The State agrees to make claims payment within seven (7) business days of receipt and acceptance of the invoice. If the Vendor’s preferred method of payment is Electronic Fund Transfer (EFT), then they will be required to set up the EFT with State Treasury.

5. The State prefers administrative claims to be sent on a monthly basis for the prior month. The State would prefer to receive monthly administrative invoices based on point-in-time enrollment with appropriate backup in excel format. The State would agree to make payment within thirty (30) business days of receipt and acceptance of the invoice. If the Vendor’s preferred method of payment is Electronic Fund Transfer (EFT), then they will be required to set up the EFT with State Treasury.

6. The State requires that the Vendor guarantees adherence to New Hampshire RSA 420-J:8-a regarding prompt pay. The law mandates timeframes for all claims [15 days electronic, 30 days paper claims, overdue (interest payment required if timeframes are not met), denied and pended (inform providers within 15 days (electronic claims) or 30 days (paper claims) and adjudicate with 45 days of receipt of additional].

7. It is the State’s standard to exchange data with its vendors using the State of New Hampshire’s Secure File Exchange Server a minimum of twice per week. The Vendor will be required to retrieve enrollment and eligibility data, as well as other related data, from this server. In addition, the Vendor will be required to use this method for sending data files to the State.

8. The State requires that the Vendor work with the State’s eligibility systems. The State currently utilizes the Global Human Resources and Human Resources Management modules of the Infor ERP (enterprise resource planning) software for human resources, benefits and payroll functions to manage the State Plan’s eligibility.

9. The State requires that the Vendor administer run-out claims for 12 months following termination of the contract. The cost of run-out administration must be included in your proposed administration fees.

10. The State requires a minimum of six (6) divisional breakouts for purposes of reporting. In addition, a lesser number of COBRA breakouts will be required.

11. The State requires the Vendor to periodically send claim and/or membership reports electronically as requested by the State.

12. The State requires a monthly wellness file to be produced and delivered securely to its third-party wellness vendor. Wellness reporting outlines subscriber participants who have had two

(2) preventive cleanings and at least one (1) evaluation by a dentist in the calendar year.

13. The State requires that appropriate staff from the Division of Risk and Benefits have online, administrative access to information and services via the Internet or through CRT interface to confirm eligibility, view participant ID card, etc.

14. The State requires that the Vendor provide the State quarterly reports detailing plan performance and address account and member service issues, federal and state legislation and legislative trends and development in the market. The State requires that the Vendor attend quarterly plan performance reviews each plan year. Additionally, the State requires an annual performance or “stewardship” meeting within 90 days after contract year-end at which time the Vendor will, as directed by the State, summarize activities and performance for the year ended.

15. The State requires Vendor to attend open enrollment meetings or other events as requested by the State.

16. The State requires a dedicated toll-free number to be made available to plan participants to handle claims or other service issues at no additional cost.

17. The State requires Vendor to provide member support services for selecting and/or locating network dentists. An on-line directory of network providers should be accessible via the member portal.

18. The State requires it be permitted to have an independent audit performed (as frequently as annually), using an auditor of its choosing, of your claim operation and will not be charged by your organization (the State would be responsible for the fees of the independent auditor).

19. The State requires that the Vendor return all recovered monies from overpayments or duplicate payments to the State. Indicate if there are any applicable collection fees in your response to Section 7.

SECTION 4

SECTION 4: NETWORK ACCESS & DISRUPTION

1. Provide the following information separately for each network you are proposing: What geographic areas constitute the service areas of your dental network within New Hampshire? Within New England (particularly Maine, Massachusetts, New Hampshire and Vermont)? How do you define whether a member is within a service area (e.g., five-digit zip, county)?

2. Complete the following separately for each network you are proposing: Using the census data provided in Appendix A [See SONH 2026 Dental RFP Data.xlsx], complete the attached network access spreadsheet using driving distance as the measurement of distance, not as the crow flies. For each geographic setting, provide the number of dentists within the area.